Rare Enough ? Cardiac Device Related Pocket Infection due to
Mycobacterium fortuitum
Abstract
Nontuberculous mycobacteria are rare causes of cardiac implantable
electronic device (CIED) pocket infections. The defibrillators are more
prone to infections when compared to pacemakers. Pocket infections may
lead to device-related endocarditis, so preventing them is key. Presence
of acid-fast bacilli on smears may aid in the diagnosis. These bacteria
grow within 3-7 days on standard agar blood culture media. Accurate
diagnosis requires PCR-restriction enzyme analysis. More often than not,
with these infections, it is strongly recommended that entire device or
hardware be removed urgently. A minimum of 4 months of therapy with at
least two agents is necessary.